What should I expect during sex therapy?

Contrary to what some people may think, you will not be physically intimate with each other while the sex therapist is watching. If having to discuss your sex life is an obstacle to getting help, you can rest assured that the sex therapist will not push you too quickly. Also, remember that an essential part of the treatment is learning how to talk about your sexual feelings more comfortably.

The role of sex therapy is to help people explore the nature and possible causes of their sexual concerns, better communicate their sexual needs and preferences, and expand their repertoire of sensual and sexual activities. By increasing the overall pleasure and intimacy of sexual contact, a couple will be able to enjoy expressions of sensuality that are free from what are often the goal-driven pressures of intercourse and orgasm.

Although intensive weeklong or weekend programs are available at a few centers around the country, most sex therapists use a modified format in which the couple meets with the therapist in his or her office for weekly 50-minute sessions. There are certified sex therapists in most major cities, so you most likely won't need to travel far from home to get help.

Much of the behavioral and relationship-building work of sex therapy is actually done at home between meetings with the therapist. After the comprehensive assessment is complete and the couple feels comfortable with and trusts the therapist, the therapist will probably assign behavioral exercises to practice at home. You'll be asked to focus on your feelings, sensations, and thoughts during the home assignment and to discuss them with the therapist in the next session.

The therapist may also serve as a sex educator. In many cases -- for example, with age-related changes or vaginal pain syndromes -- understanding the physiological basis of the problem often goes a long way toward relieving your anxiety, as well as your partner's. The therapist will discuss such issues with you during therapy sessions and may suggest useful books and DVDs. He or she will also help you question erroneous beliefs and assumptions that stand in the way of enjoyable sex, such as "All sexual contact must lead to intercourse," "The man must be in charge of the sexual activity," or "Foreplay is only for teenagers and isn't really sex."